Antidepressant-Induced Mania Risk Factors and Prevention

Clinical Characteristics and Timing

Behavioral activation/agitation typically occurs early (first month) or with dose increases, whereas true mania/hypomania may appear later in treatment course, according to the American Academy of Child and Adolescent Psychiatry 1, 2
The American Academy of Child and Adolescent Psychiatry recommends distinguishing between behavioral activation and mania, as behavioral activation usually improves quickly after dose reduction, whereas mania persists and requires active pharmacological intervention 1, 2

The American Academy of Child and Adolescent Psychiatry suggests that antidepressants should only be used as adjuncts when patients are taking at least one mood stabilizer, in known bipolar disorder 3